Nearly half of critically ill children with a pediatric intensive care unit (PICU) length of stay >48hrs will receive a transfusion of packed red blood cells (pRBC). Despite evidence that a lower hemoglobin threshold for pRBC transfusion in the PICU is safe, multiple studies have shown that the threshold in practice is much higher, exposing children to the significant morbidity and mortality associated with pRBC. Therefore there is increased need for evidence- based blood management strategies for clinicians caring for critically ill children aimed to maintain a physiologically relevant hemoglobin concentration, optimize hemostasis and minimize blood loss in an effort to improve patient outcomes. There remains a paucity of research in this area for children so a research guide is desperately needed. The Pediatric Critical Care Transfusion and Anemia Expertise Initiative (TAXI), in collaboration with the Pediatric Critical Care Blood Research Network (BloodNet), the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI), the American Association of Blood Banks (AABB) and the Society for Critical Care Medicine (SCCM), proposes a conference series led by international and multidisciplinary experts to develop pediatric critical care blood management consensus for clinical guidance and future research efforts. This group will create a comprehensive series of consensus statements via an organized and structured process over 2 years to outline existing data and future research foci in the area of pRBC transfusions in critically ill children. TAXI has obtained letters of agreement/support from over 40 international experts for this project, as well as from the SCCM and the AABB, who are actively engaged and positioned to endorse the consensus products. Novel features of this initiative include early engagement with formal implementation science, medical anthropology and human factor engineering experts, so that we may best guide consensus statement uptake in order to improve outcomes and safety for children at risk for, or who require, pRBC transfusion. The consensus statements will include specific strategies for adaptive dissemination and implementation into various clinical/research environments. It will also be imperative that the statements be developed with an approach that accounts for the challenges in the environment and overall medical culture that may limit wide application and dissemination of the statement's recommendations.